Impact of Patient Demographic Factors on Preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, Pain Interference, and Depression Computer Adaptive Testing Scores in Patients Undergoing Shoulder and Elbow Surgery

Background: There has been a growing emphasis in orthopaedics on providing patient-centered care. The US National Institutes of Health launched the Patient-Reported Outcomes Measurement Information System (PROMIS) initiative that incorporates patient-reported outcome measures across a number of medical domains. The relationship between PROMIS domains and the impact of patient demographic factors in those undergoing upper extremity surgery remains unclear. Purpose/Hypothesis: The goal of this study was to investigate the correlation between physical function, pain interference, and depression in patients undergoing shoulder and elbow surgery as measured by PROMIS computer adaptive testing (CAT) forms and to determine the impact of patient demographic factors. We hypothesized that there would be a significant negative correlation between physical function and both pain interference and depression in this patient population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All patients who underwent elective shoulder or elbow surgery by 3 shoulder, elbow, and/or sports medicine fellowship–trained orthopaedic surgeons were included in the study. Preoperative PROMIS–Upper Extremity (PROMIS-UE), PROMIS–Pain Interference (PROMIS-PI), and PROMIS-Depression (PROMIS-D) CAT scores were analyzed. Pearson correlations were calculated between PROMIS domains as well as between PROMIS outcomes with patient demographic factors. Results: Preoperative PROMIS CAT scores for all 3 domains were collected and analyzed from 172 unique patients (516 individual CAT forms) with shoulder and elbow injuries. A negative correlation of moderate strength was found between the PROMIS-UE and PROMIS-PI (R = –0.61; P \u3c.001), and a negligible correlation was found between the PROMIS-UE and PROMIS-D (R = –0.28; P \u3c.001). When stratified by patient demographic factors, the correlation between the PROMIS-UE and PROMIS-PI was stronger in female patients compared with male patients (R = –0.77 vs –0.46, respectively; P \u3c.001 for both), stronger in black patients compared with white patients (R = –0.72 vs –0.56, respectively; P \u3c.001 for both), and highest in current tobacco users (R = –0.80; P \u3c.001). Conclusion: Before shoulder and elbow surgery, patients demonstrated impairments in physical function and pain interference as measured by CAT forms, with a moderate negative correlation between baseline upper extremity physical function and pain interference scores. In certain subpopulations, such as female patients, black patients, and current tobacco users, the correlations between these tested domains were stronger than in other groups

Measuring User Satisfaction for the Natural Hazards Engineering Research Infrastructure Consortium

The User Forum is a Natural Hazards Engineering Research Infrastructure (NHERI)-wide group focused on providing the NHERI Council with independent advice on community user satisfaction, priorities, and needs relating to the use and capabilities of NHERI. The User Forum has representation across NHERI activities, including representatives working directly with the Network Coordination Office (NCO), Education and Community Outreach (ECO), Facilities Scheduling, and Technology Transfer efforts. The User forum also provides feedback on the NHERI Science Plan. As the community voice within the governance of NHERI, the User Forum is composed of members nominated and elected by the NHERI community for a specified term of 1–2 years. User Forum membership spans academia and industry, the full breadth of civil engineering and social science disciplines, and widespread hazard expertise including earthquakes, windstorms, and water events. One of the primary responsibilities of the User Forum is to conduct an annual community user satisfaction survey for NHERI users, and publish a subsequent Annual Community Report. Measuring user satisfaction and providing this feedback to the NHERI Council is critical to supporting the long-term sustainability of NHERI and its mission as a multidisciplinary and multi-hazard network. In this paper, the role and key activities of the User Forum are described, including User Forum member election procedures, User Forum member representation and roles across NHERI activities, and the processes for measuring and reporting user satisfaction. This paper shares the user satisfaction survey distributed to NHERI users, and discusses the challenges to measuring community user satisfaction based on the definition of user. Finally, this paper discusses the evolving approaches of measuring user satisfaction using other methods, including engaging with the twelve NHERI research infrastructures

Collective Sensemaking Around COVID-19: Experiences, Concerns, and Agendas for our Rapidly Changing Organizational Lives

Uncertainty is at the forefront of many crises, disasters, and emergencies, and the COVID-19 pandemic is no different in this regard. In this forum, we, as a group of organizational communication scholars currently living in North America, engage in sensemaking and sensegiving around this pandemic to help process and share some of the academic uncertainties and opportunities relevant to organizational scholars. We begin by reflexively making sense of our own experiences with adjusting to new ways of working during the onset of the pandemic, including uncomfortable realizations around privilege, positionality, race, and ethnicity. We then discuss key concerns about how organizations and organizing practices are responding to this extreme uncertainty. Finally, we offer thoughts on the future of work and organizing informed by COVID-19, along with a list of research practice considerations and potentially generative research questions. Thus, this forum invites you to reflect on your own experiences and suggests future directions for research amidst and after a cosmology event

The uptake of soluble and nanoparticulate imaging isotope in model liver tumours after intra-venous and intra-arterial administration

Delivery of chemotherapeutic drugs to tumours by reformulation as nanoparticles has often been proposed as a means of facilitating increased selective uptake, exploiting the increased permeability of the tumour vasculature. However realisation of this improvement in drug delivery in cancer patients has met with limited success. We have compared tumour uptake of soluble Tc99m-pertechnetate and a colloid of nanoparticles with a Tc99m core, using both intra-venous and intra-arterial routes of administration in a rabbit liver VX2 tumour model. The radiolabelled nanoparticles were tested both in untreated and cationised form. The results from this tumour model in an internal organ show a marked advantage in intra-arterial administration over the intra-venous route, even for the soluble isotope. Tumour accumulation of nanoparticles from arterial administration was augmented by cationisation of the nanoparticle surface with histone proteins, which consistently facilitated selective accumulation within microvessels at the periphery of tumours.Sources of support for this research: Sirtex Medical Ltd, Sydney Australia

Assessing the quality of footwear marks recovered from simulated graves

Footwear marks are one of the most frequently encountered evidence types recovered from a crime scene and can provide valuable scene intelligence regarding potential suspects. It has been acknowledged that impressions of footwear and tools can be recovered from graves, but previous studies have only focused on tool mark recovery. This has led to a lack of published information regarding footwear mark recovery from graves. It is therefore important to demonstrate whether the recovery of footwear marks is feasible and, if so, under what conditions this can be achieved. To address recovery, this study, placed 60 three dimensional (3D) impressions of footwear marks within 60 simulated graves. This was done to assess time (1, 2, 4 months) and at known depths (20, 30, 40 cm). The footwear marks within the graves were covered with clothing or left uncovered. The shoe’s design patterns were grouped and counted in a photographic comparison between the 3D footwear impressions, placed within the test-pits, and any recovered impressions. A grading system was adapted by the authors to score the quality of footwear impressions observed during recovery. The results demonstrate that the preservation and recovery of footwear impressions from graves is feasible. The simulated graves covered with clothing showed better preservation of footwear impressions, but there was no clear evidence that time or depth had an effect. The authors note that careful consideration and vigilant excavation skills are needed when excavating graves which may bear potential footwear marks, as their recovery will lead to an increased amount of intelligence that can link suspects to homicide scenes

In vivo tumour imaging employing regional delivery of novel gallium radiolabelled polymer composites

Background: Understanding the regional vascular delivery of particles to tumour sites is a prerequisite for developing new diagnostic and therapeutic composites for treatment of oncology patients. We describe a novel imageable 67Ga-radiolabelled polymer composite that is biocompatible in an animal tumour model and can be used for preclinical imaging investigations of the transit of different sized particles through arterial networks of normal and tumour-bearing organs. Results: Radiolabelling of polymer microspheres with 67Ga was achieved using a simple mix and wash method, with tannic acid as an immobilising agent. Final in vitro binding yields after autoclaving averaged 94.7%. In vivo stability of the composite was demonstrated in New Zealand white rabbits by intravenous administration, and intrahepatic artery instillations were made in normal and VX2 tumour implanted rabbit livers. Stability of radiolabel was sufficient for rabbit lung and liver imaging over at least 3 hours and 1 hour respectively, with lung retention of radiolabel over 91%, and retention in both normal and VX2 implanted livers of over 95%. SPECT-CT imaging of anaesthetised animals and planar imaging of excised livers showed visible accumulation of radiolabel in tumours. Importantly, microsphere administration and complete liver dispersal was more easily achieved with 8 μm diameter MS than with 30 μm MS, and the smaller microspheres provided more distinct and localised tumour imaging. Conclusion: This method of producing 67Ga-radiolabelled polymer microspheres is suitable for SPECT-CT imaging of the regional vascular delivery of microspheres to tumour sites in animal models. Sharper distinction of model tumours from normal liver was obtained with smaller MS, and tumour resolution may be further improved by the use of 68Ga instead of 67Ga, to enable PET imaging.The ANU authors acknowledge the collaborative research project support generously provided to ANU by Sirtex Medical Ltd. (Sydney), including donation of a GE Hawkeye Infinia SPECT/CT scanner and a Xeleris image processing system

A gain-of-function variant in <i>DIAPH1 </i>causes dominant macrothrombocytopenia and hearing loss

Macrothrombocytopenia (MTP) is a heterogeneous group of disorders characterized by enlarged and reduced numbers of circulating platelets, sometimes resulting in abnormal bleeding. In most MTP, this phenotype arises because of altered regulation of platelet formation from megakaryocytes (MK). We report the identification of DIAPH1, which encodes the Rho-effector diaphanous-related formin 1 (DIAPH1), as a candidate gene for MTP using exome sequencing, ontological phenotyping and similarity regression. We describe two unrelated pedigrees with MTP and sensorineural hearing loss that segregate with a DIAPH1 p.R1213* variant predicting partial truncation of the DIAPH1 diaphanous autoregulatory domain. The R1213* variant was associated with reduced proplatelet formation from cultured MKs, cell clustering and abnormal cortical filamentous actin. Similarly, in platelets there was increased filamentous actin and stable microtubules, indicating constitutive activation of DIAPH1. Over-expression of DIAPH1 R1213* in cells reproduced the cytoskeletal alterations found in platelets. Our description of a novel disorder of platelet formation and hearing loss extends the repertoire of DIAPH1-related disease and provides new insights into the autoregulation of DIAPH1 activity

Spatiotemporal dynamics of word retrieval in speech production revealed by cortical high-frequency band activity.

Word retrieval is core to language production and relies on complementary processes: the rapid activation of lexical and conceptual representations and word selection, which chooses the correct word among semantically related competitors. Lexical and conceptual activation is measured by semantic priming. In contrast, word selection is indexed by semantic interference and is hampered in semantically homogeneous (HOM) contexts. We examined the spatiotemporal dynamics of these complementary processes in a picture naming task with blocks of semantically heterogeneous (HET) or HOM stimuli. We used electrocorticography data obtained from frontal and temporal cortices, permitting detailed spatiotemporal analysis of word retrieval processes. A semantic interference effect was observed with naming latencies longer in HOM versus HET blocks. Cortical response strength as indexed by high-frequency band (HFB) activity (70-150 Hz) amplitude revealed effects linked to lexical-semantic activation and word selection observed in widespread regions of the cortical mantle. Depending on the subsecond timing and cortical region, HFB indexed semantic interference (i.e., more activity in HOM than HET blocks) or semantic priming effects (i.e., more activity in HET than HOM blocks). These effects overlapped in time and space in the left posterior inferior temporal gyrus and the left prefrontal cortex. The data do not support a modular view of word retrieval in speech production but rather support substantial overlap of lexical-semantic activation and word selection mechanisms in the brain

Saccharomyces cerevisiae: Population Divergence and Resistance to Oxidative Stress in Clinical, Domesticated and Wild Isolates

BACKGROUND: Saccharomyces cerevisiae has been associated with human life for millennia in the brewery and bakery. Recently it has been recognized as an emerging opportunistic pathogen. To study the evolutionary history of S. cerevisiae, the origin of clinical isolates and the importance of a virulence-associated trait, population genetics and phenotypic assays have been applied to an ecologically diverse set of 103 strains isolated from clinics, breweries, vineyards, fruits, soil, commercial supplements and insect guts. METHODOLOGY/PRINCIPAL FINDINGS: DNA sequence data from five nuclear DNA loci were analyzed for population structure and haplotype distribution. Additionally, all strains were tested for survival of oxidative stress, a trait associated with microbial pathogenicity. DNA sequence analyses identified three genetic subgroups within the recombining S. cerevisiae strains that are associated with ecology, geography and virulence. Shared alleles suggest that the clinical isolates contain genetic contribution from the fruit isolates. Clinical and fruit isolates exhibit high levels of recombination, unlike the genetically homogenous soil isolates in which no recombination was detected. However, clinical and soil isolates were more resistant to oxidative stress than any other population, suggesting a correlation between survival in oxidative stress and yeast pathogenicity. CONCLUSIONS/SIGNIFICANCE: Population genetic analyses of S. cerevisiae delineated three distinct groups, comprising primarily the (i) human-associated brewery and vineyard strains, (ii) clinical and fruit isolates (iii) and wild soil isolates from eastern U.S. The interactions between S. cerevisiae and humans potentiate yeast evolution and the development of genetically, ecologically and geographically divergent groups

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy